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Biomedical subjects

S Ishihara

Publications and source records attributed to S Ishihara.

At least 325 records · Page 18Linked to original sources
PubMed1989

[A case of the successful surgical treatment of mediastinal giant neurogenic tumor, and the chest wall reconstruction by the autologous ribs].

A mediastinal tumor, particularly a neurogenic tumor, sometimes develops into a giant tumor; this large tumor mass then puts pressure on the heart and lungs, and may cause severe complications. In our department, 164 mediastinal tumors were experienced, the largest one was an intrathoracic fibromyoma which weighed 3,760 g. This report deals with our recent experience in which we found a neurogenic tumor weighed out 4,500 g. This tumor was excised in an emergency operation, after which the patient's life was saved by twenty-two days of artificial respiration. Since this tumor was so large, four entire right ribs had to be removed in order to create enough space to excise it. In order to reconstruct the chest wall, three of the removed ribs were retransplanted in their original sites. An extremely good prognosis resulted.

Adult↗
PubMed1989

[A case of complete disruption of right truncus intermedius treated by operation].

A case of right bronchial disruption caused by blunt chest trauma was successfully operated. Patient is a 35-year-old woman who was transferred to our intensive care unit with markedly dyspnea and subcutaneous emphysema. Rupture of right bronchus was suspected by chest x-ray film and bronchial fiberscopy. An emergency thoracotomy was performed with the aid of selective lung ventilation by the use of double lumen endobronchial tube. Right bronchus was completely transected and small part of upper lobe was lacerated. Right bronchus was anastomosed directly with interrupted 3-0 vinyl sutures and laceration of upper lobe was sutured. Postoperative course was uneventful, but postoperative bronchoscopy confirmed slight stenosis of the anastomotic position. Prompt diagnosis by bronchoscopy and emergency thoracotomy followed by selective lung ventilation are mandatory in this patient survival.

Adult↗
PubMed1989

[A successful cryosurgical treatment of malignant ventricular tachycardia following left ventricular aneurysm].

A 61-year-old man underwent cryoablation in addition to aneurysmectomy and single aorto-coronary bypass for sustained ventricular tachycardia (VT) following left ventricular aneurysm. Two types of VT were observed clinically and electrophysiologically with programmed stimulation. During operation, VT was induced but could not be maintained on normothermic cardio-pulmonary bypass. Therefore cryoablation was performed on the two sites where the delayed potentials were recorded. Postoperatively recurrence of VT was never recognized clinically and electrophysiologically.

Cryosurgery↗
PubMed1989

[Clinical study of male sterility patients].

We report the results of a clinical study of the male sterility in our institute during the past 55 months. A total of 187 male patients consulted us with the complaint of sterility, and the semen of 173 patients was examined, sixty two cases were diagnosed as azoospermia, 34 as severe oligozoospermia, 17 as moderate oligozoospermia and 60 cases as normospermia. Based upon the results of semen examination, endocrinological examination and so on, 78 cases were diagnosed as idiopathic spermatogenetic dysfunction. Serum follicle stimulating hormone (FSH) levels in azoospermia patients were significantly higher than those of normal males statistically, and the serum FSH level was considered to correlate with the damage of spermatogenesis. We performed serial treatment using kallikrein and/or human chorionic gonadotropin, on 44 patients. Only patient, who was treated with a high dose kallikrein, succeeded in impregnating his spouse. Four of our patients with oligozoospermia had received chemotherapy for testicular cancer. Recently, with the progress of anticancer chemotherapy, curative cases have increased gradually. However, because of adverse reaction, oligozoospermia cases have also increased. Considering the quality of life, the management of the sterility may be very important.

Adult↗
PubMed1989

[A case of adenocarcinoma of the bladder infiltrating to sigmoid colon].

A 65-year-old man was admitted to our clinic with the chief complaint of gross hematuria and burning on urination. Cystoscopy revealed a papillary broad base tumor on right lateral and posterior wall. Barium enema showed a tumor of sigmoid colon. The other gastrointestinal and genitourinary tracts were examined but no tumor lesion could be found. Total cystectomy and partial resection of sigmoid colon were done, and the urinary tract was reconstructed using a Kock continent ileal reservoir. Histological findings revealed adenocarcinoma of its infiltration to the sigmoid colon.

Adenocarcinoma↗
PubMed1989

[A successful case report of aortic valve replacement in aortitis c AR].

A 36-year-old female was referred as aortitis c AR with atypical coarctation of aorta (obstruction of both subclavian arteries and long stenosis of lt. common carotid artery) and complained of untolerable angina repeatedly in the state of NYHA IV. AVR was performed successfully and CHF symptoms were disappeared. In the operation, pulsatile high flow was maintained using PAD during ECC for the protection of brain and kidney and double patch was used to fix SJM 23 A. Postoperative catheterization showed good cardiac function without valve detachment. To prevent valve detachment, it was most important to control the inflammation sufficiently by steroid hormone before and after the operation.

Adult↗
PubMed1989

[Intracardiac repair in anatomically corrected malposition of the great arteries (SDL): report on 2 successful repair].

Two cases of anatomically corrected malposition of the great arteries (SDL) with aorto-mitral fibrous continuity and pulmonary-tricuspid discontinuity are presented. Case 1 was a 24-year-old male with an associated ventricular septal defect (VSD) and pulmonary stenosis. Case 2 was a 1-year-old boy also with VSD. Both cases successfully underwent total correction. The aorto-mitral fibrous continuity was verified in both cases through right ventriculotomy during the operation. The postoperative course was uneventful in both cases and they have remained asymptomatic 5 years after operation. We believe this report to be the first one of anatomically corrected malposition of the great arteries with aorto-mitral fibrous continuity.

Adult↗
PubMed1989

[Direct aortic reimplantation for BWG syndrome including mitral valve repair].

Direct aortic reimplantation is the ideal treatment for the BWG syndrome, but is often impossible to obtain a sufficient length of the coronary artery without undue tension on the vessel. We experienced a 6-year-old boy whose left coronary artery was originated from pulmonary trunk widely distant from aorta. Direct reimplantation was successfully performed taking care of excising the ostium of the anomalous vessel as a largest flange and mobilizing the coronary artery from the adjacent tissue sufficiently. Mitral valve regurgitation is also a poor prognosis factor of BWG syndrome. We performed direct reimplantation and mitral valve repair (anterior commissuroplasty) simultaneously to a 3-year-old boy of BWG syndrome with severe mitral valve regurgitation. Postoperative data showed improvement of cardiac performance. Possibility of recovering the papillary muscle function by valve repair without replacement was suggested.

Aorta↗
PubMed1989

Molecular analysis of acute undifferentiated leukemia: two distinct subgroups at the DNA and RNA levels.

On the basis of negativity for myeloperoxidase (MPO) and absence of lineage-associated antigens on the cell surface, 11 children were diagnosed as having acute undifferentiated leukemia. To analyze the molecular events associated with hematopoietic cell differentiation, we analyzed the configuration of the immunoglobulin (Ig) and T-cell receptor (TCR) delta, alpha, gamma, and beta genes in these patients. In parallel, transcription of the genes for MPO, terminal deoxynucleotidyltransferase (TdT), CD3-gamma, Ig-mu, TCR-gamma, and beta was also examined. Six patients showed rearrangements of both the Ig heavy (H) and TCR-delta genes, frequently accompanied with Ig-kappa, TCR-alpha, gamma, and beta gene rearrangements. These findings indicated that the leukemic cells from the six patients had been committed to the lymphoid lineage. This concept was supported by the presence of TdT transcripts in three analyzed specimens from these patients. In contrast, the remaining five patients did not display rearrangements of the Ig or TCR genes, and TdT transcripts were undetectable in two patients tested. MPO transcripts were not detected in four patients analyzed, thus providing no evidence of myeloid differentiation. After hybridization with the CD3-gamma gene, three of six patients showed transcription of the CD3-gamma gene. In addition to CD3-gamma transcripts, one patient with rearrangements of the Ig-H, TCR-delta, alpha, gamma, and beta genes also had full-length TCR-beta and gamma transcripts, indicating a T-precursor-cell origin of the leukemic cells from this patient. The Ig and TCR genes were in the germline configuration in the other two patients with CD3-gamma transcripts. One of them did not express the CD7 antigen but did express the CD33 antigen on the cell surface, suggesting that CD3-gamma transcription may not always be an event restricted to cells differentiating along the T-cell lineage.

Acute Disease↗
PubMed1989

[An urgent successful operation for aortic regurgitation with chronic renal failure, low cardiac function and recurrent ventricular tachycardia].

A 63-year-old man had suffered from congestive heart failure due to aortic valve regurgitation and had followed chronic renal failure. Left ventricular ejection fraction revealed 18% and Creatinine Clearance value was 8 ml/min. What is worse, recurrent ventricular tachycardia resulted in disturbance of consciousness and cardiogenic shock. As the medical therapy was no more effective, aortic valve replacement was done urgently. During the operation, myocardial protection was performed adequately and hemodialysis was used. Postoperatively peritoneal dialysis was employed. As a result these means facilitated the intraoperative and postoperative management of the patient. He became well and then was discharged. Successful operation can be performed in the face of severe cardiac and renal failure under the careful and proper management.

Aortic Valve Insufficiency↗
PubMed1988

The P wave in the magnetocardiogram.

The P wave of the magnetocardiogram (MCG) was investigated in normal subjects and in patients with right and left atrial overloading. In normal subjects, the MCG P wave was positive at right lower sternal sites and negative in the other portions. The current source deduced from the MCG and the isomagnetic map was directed inferiorly and to the left throughout the entire phase of atrial activation. In patients with right atrial overloading, the direction of the current source deduced from the MCG was similar to that of normal subjects, but its amplitude was significantly greater. In left atrial overloadings, a negative-positive biphasic P wave was seen more frequently than in normal subjects at left parasternal sites. In the late phase of atrial activation, the MCG could detect the two dipoles, i.e. one directed inferiorly and other directed to the left. These dipoles might correspond to right and left atrial activities, respectively. These results show that the MCG might add useful information on current source to the conventional electrocardiogram.

Adult↗
PubMed1988

Angiotensin-converting enzyme inhibitors. 2. Perhydroazepin-2-one derivatives.

alpha-[(3S)-3-[[(S)-1-(Ethoxycarbonyl)-3-phenylpropyl]amino]-2-oxo-6 or 7-phenylperhydroazepin-1-yl]acetic acids (monoester monoacids) and their dicarboxylic acids were synthesized, and their angiotensin-converting enzyme (ACE) inhibitory activities were evaluated. The dicarboxylic acids having phenyl substituents at the 6R, 6S, and 7S positions on the azepinone ring showed potent inhibition in vitro. The corresponding monoester monoacids, when administered orally, suppressed the pressor response to angiotensin I administered intravenously. The monoester monoacids having the phenyl substituent at the 6-position showed a longer duration of action than one having the substituent at the 7-position. The structure-activity relationship was studied on the basis of the conformational energy calculation.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1988

T-cell receptor beta-chain gene expression in B-lineage acute lymphoblastic leukemia.

The T-cell receptor beta-chain (T beta) gene expression was examined in 16 children with B-lineage acute lymphoblastic leukemia (ALL), including eight patients with rearrangement of the T beta gene as well as immunoglobulin (Ig) heavy chain gene rearrangement. In contrast to the 1.3 kb full-length transcripts of the T beta observed in T-lineage leukemia and lymphoma cells, no transcript of the T beta gene was detected in 10 patients, including four with T beta gene rearrangement. Low levels of T beta transcripts were found in three patients with T beta gene rearrangement and two patients without T beta gene rearrangement, but those transcripts were truncated. In contrast to those findings, a single patient with T beta gene rearrangement showed abundant 1.3 kb T beta transcripts. These data indicate that T beta gene expression is not restricted to T-lineage cells and demonstrate the heterogeneity of B-lineage ALL at the expression level of the T beta gene. Our findings also suggest that T beta gene expression is not always accompanied with T beta gene rearrangement.

B-Lymphocytes↗
PubMed1988

Inhibitory effects of estradiol on glycogen synthesis in primary cell cultures of human endometrium.

The effect of estradiol on glycogen synthesis was examined in a primary cell culture system of the human endometrium. Estradiol inhibited glycogen synthesis in a dose dependent manner with a minimum effective dose of 10(-9)M. Progesterone-induced glycogen synthesis was completely abolished by the simultaneous addition of estradiol. Estradiol did not affect the activity of glycogen phosphorylase in endometrial cells, but the activity of glycogen synthetase was decreased by estradiol irrespective of the presence of progesterone. The inhibitory effect of estradiol on the glycogen synthesis of endometrial cells seemed to be mediated by estradiol receptor, because LY156758, an antiestrogenic drug at receptor site, reversed the inhibitory effect of estradiol.

Adult↗
PubMed1988

[Basic studies on an immunoradiometric assay system for human parathyrin (intact PTH1-84)].

Two-site immunoradiometric assay for human parathyrin (PTH1-84) is specific for the intact, secreted, biologically active 84 amino peptide. This system incorporates two-different polyclonal antibodies to human intact PTH and has several technical advantages for use. This assay could detect a wide range of PTH in patients with hypo-, hyperparathyroidism, chronic renal failure and hypercalcemia with malignancy, especially distinguishing the level of human intact PTH in hypoparathyroidism from in normal.

Humans↗
PubMed1988

[A case of xanthogranulomatous pyelonephritis--an experience of echo-guided aspiration biopsy for the diagnosis].

Xanthogranulomatous pyelonephritis is a rare disease of the kidney. The pre-operative diagnosis of this disease is usually very difficult. Recently, echo-guided aspiration biopsy has been suggested for the differential diagnosis of the renal mass. We experienced a case of xanthogranulomatous pyelonephritis and performed echo-guided aspiration biopsy. A 57-year-old female was admitted to our hospital with complaints of upper abdominal pain and right lumbago. Judging from the findings obtained by intravenous pyelography, computed tomographic scan, ultrasonography and angiography, the lesion was a right renal inflammatory mass but renal tumor could not be denied. Because clear cell carcinoma was suspected from the results of echo-guided aspiration biopsy, right radical nephrectomy was performed. However, the resected kidney was diagnosed to be xanthogranulomatous pyelonephritis. Post-operative course was uneventful.

Adenocarcinoma↗